Individual provider Active NPI

Michael Jay Hess Jr.

  • Physician Assistant
  • Staten Island, NY
National Provider Identifier
1790169803
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00372100 Issued in NJ
Practice address
6 Kerry LN
Staten Island, NY 10307-2074
Phone
(718) 967-3035
NPI assigned
Jul 17, 2015
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00372100 NJ Primary

Addresses

Primary practice location

6 Kerry LN
Staten Island, NY 10307-2074

Mailing address

3600 Route 66
FL 3
Neptune, NJ 07753-2645
Phone (732) 807-0800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170113000038 NJ Practitioner - Physician Assistant 3678855327 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 12, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC PastSince Oct 23, 2022 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1790169803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66",
            "address_2": "FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645",
            "telephone_number": "732-807-0800",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 KERRY LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103072074",
            "telephone_number": "718-967-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESS",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00372100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.